Ahn Sun Ho, Mayo-Smith William W, Murphy Brian L, Reinert Steven E, Cronan John J
Department of Diagnostic Imaging, Brown Medical School and Rhode Island Hospital, 593 Eddy St, Providence, RI 02903, USA.
Radiology. 2002 Oct;225(1):159-64. doi: 10.1148/radiol.2251011282.
To compare the diagnostic yield of abdominal radiography with that of computed tomography (CT) in adult patients presenting to the emergency department with nontraumatic abdominal pain.
Records of 1,000 consecutive patients presenting to the emergency department with acute abdominal pain from April to June 1998 were retrospectively reviewed. A total of 871 patients underwent abdominal radiography, and 188 underwent abdominal CT. The report interpretations of the abdominal radiographs and CT scans were divided into normal, nonspecific, and abnormal categories. Final discharge diagnoses were compared with the interpretations of the imaging examination results, and sensitivities and specificities of each modality were calculated and compared.
Interpretation of abdominal radiographs was nonspecific in 588 (68%) of 871 patients, normal in 200 (23%), and abnormal in 83 (10%). The highest sensitivity of abdominal radiography was 90% for intraabdominal foreign body and 49% for bowel obstruction. Abdominal radiography had 0% sensitivity for appendicitis, pyelonephritis, pancreatitis, and diverticulitis. Sensitivities of abdominal CT were highest for bowel obstruction and urolithiasis at 75% and 68%, respectively.
Abdominal radiographs are not sensitive in the evaluation of adult patients presenting to the emergency department with nontraumatic abdominal pain.
比较腹部X线摄影与计算机断层扫描（CT）对因非创伤性腹痛就诊于急诊科的成年患者的诊断效能。
回顾性分析1998年4月至6月期间连续1000例因急性腹痛就诊于急诊科患者的记录。共有871例患者接受了腹部X线摄影，188例接受了腹部CT检查。腹部X线片和CT扫描的报告解读分为正常、非特异性和异常三类。将最终出院诊断与影像检查结果的解读进行比较，并计算和比较每种检查方式的敏感性和特异性。
871例患者中，588例（68%）的腹部X线片解读为非特异性，200例（23%）为正常，83例（10%）为异常。腹部X线摄影对腹内异物的最高敏感性为90%，对肠梗阻为49%。腹部X线摄影对阑尾炎、肾盂肾炎、胰腺炎和憩室炎的敏感性为0%。腹部CT对肠梗阻和尿路结石的敏感性最高，分别为75%和68%。
腹部X线片对因非创伤性腹痛就诊于急诊科的成年患者评估不敏感。
